Majority of women responded well and returned to normal histology in six months

HealthDay News — A levonorgestrel-releasing intrauterine device (LNG-IUD) is effective in the majority of patients undergoing conservative treatment for low-risk endometrial cancer and complex atypical hyperplasia, according to a case-series study published online December 4 in Obstetrics & Gynecology.

Navdeep Pal, MBBS, MPH, from the University of Texas MD Anderson Cancer Center in Houston, and colleagues retrospectively reviewed 46 cases treated with the LNG-IUD for complex atypical hyperplasia or early-grade endometrial cancer from January 2003 to June 2013.

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The researchers found that 15 of the 32 evaluable patients at the 6-month time point had complex atypical hyperplasia (47%), 9 had G1 endometrial cancer (28%), and 8 had grade 2 endometrial cancer (25%). At 6 months, the overall response rate was 75% (80% in complex atypical hyperplasia, 67% in grade 1 endometrial cancer, and 75% in grade 2 endometrial cancer). There was a trend toward an association between lack of exogenous progesterone effect in the pathology specimen and nonresponse to the IUD (P=0.05). In women who did not respond to the IUD, median uterine diameter was 1.3 cm larger (P=0.04).

"Levonorgestrel-releasing IUD therapy for the conservative treatment of complex atypical hyperplasia or early-grade endometrial cancer resulted in return to normal histology in a majority of patients," the authors write.